骨科Ⅰ类切口手术预防性使用抗菌药物调查分析

Analysis of Prophylactic Use of Antibiotics in Orthopedic Patients with Type Ⅰ Incision

目的了解某院骨科围手术期抗菌药物的应用情况。方法以《抗菌药物临床应用指导原则》为指南,随机抽取2009年4～12月某院骨科Ⅰ类切口手术,预防性使用抗菌药物患者200例,填写患者基本情况和用药情况调查表,对数据进行统计分析。结果术前24h应用抗菌药物者占6.5%,术后应用抗菌药物者占1.5%;术后用药时间超过规定者占81.0%;单一用药者占74.0%,二联用药者占25.0%。调查涉及抗菌药物18个品种,列前五位的抗菌药物分别是左氧氟沙星、头孢美唑、头孢硫脒、夫西地酸钠、萘夫西林钠。结论该院骨科围手术期抗菌药物的预防性使用基本合理,但是存在抗菌药物品种高选,用药时机不当,术后用药时间过长等问题,有待进一步规范化管理。

Objective To investigate and analyze the prophylactic use of antibiotics for perioperative patients in orthopedic surgery.Methods 200 perioperative patients were sampled randomly from Apr.to Dec.2009 in a hospital.The general data and medication of the patients were analyzed statistically based on the Guiding Principle of the Clinical Application of Antibacterials.Results The application ratios of antibacterials use of 24 h before operation and after operation were 6.5 % and 1.5% respectively.The rate of medication duration of antibiotics which exceeded the time of antibiotic instruction principle was 81.0%.There were 74.0% for the single use of antibiotics and 25.0% for the combined use of two kinds antibiotics.18 kinds of antibacterials use were analysed and the top 5 were levofloxacin,cefmetazole sodium,cefathiamidine,fusidate sodium,nafcillin sodium.Conclusion The antibacterials use for perioperative patients in orthopedic surgery of this hospital was overall reasonable,but some problems still exist such as the high selection of prophylactic drug use,improper time of drug use,and the prolonged continuous drug use,which requires the strengthening of standardized management for prophylactic antibiotics use.